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Does Medicare Cover Anoro?

Does Medicare Cover Anoro?

COPD can be treated with the medication known as Anoro Ellipta (umeclidinium/vilanterol). Anoro is an anticholinergic and beta-agonist combination medicine.

So a common question many people have is, “Does Medicare cover Anoro?”

In this article, we answer the question in clear, plain English. You will also find the average costs of Anoro and other helpful info.

Does Medicare Cover Anoro?

The short answer is no. In most cases, Medicare will not cover the cost of Anoro. There may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your Anoro. 

Original Medicare Coverage of Anoro

Original Medicare (Medicare Part A and Part B) does not provide coverage for Anoro. Typically, this plan covers necessary services, equipment, and treatment rather than prescription drugs.

Prescription drug coverage may be provided by either Medicare Advantage plans or Medicare Part D.  

Medicare Advantage Coverage of Anoro

On the other hand, some Medicare Advantage plans (Medicare Part C) provide coverage for Anoro. Medicare Advantage plans cover everything Original Medicare covers but will often offer some additional benefits. 

However, coverage and out-of-pocket costs will vary depending on the Advantage plan you have. Medicare Part C plans that include drug plans will also cover these medications upon prescription.

Medicare Part D Coverage of Anoro

Medicare Part D plans also provide coverage for Anoro. Medicare Part D is a prescription drug plan. Like Medicare Part C, Medicare Part D plans are provided by private insurance companies. Eighty-seven percent of Medicare Part C and Part D plans cover the medication Anoro. 

Amount of Anoro Allowed Per Purchase

Some Medicare plans restrict the amount of purchase for Anoro per one time. If you need to purchase more Anoro at one time, Medicare may not cover it. 

You have a couple of options. You can wait until the period has passed before refilling. Or, if you need to purchase more Anoro, you can contact your plan provider and ask for an exception. Anoro is listed as a tier 3 drug in the Medicare drug formulary. 

Most of the time, the Medicare drug formulary has five tiers. Tier 3 medications are preferred branded medications. Tier 3 medications are also more expensive than Tier 1 and 2 medications.

How Much Does Anoro Cost?

The average cost of 60 blisters of 62.5 mcg/25 mcg aerosol powder Anoro is $583. 

Anora is significantly more popular than other brands. There is not yet a generic equivalent available for Anoro Ellipta at this time.

Medicare Coverage of COPD 

Otherwise, you can get coverage for asthma inhalers. This can be covered by Part B as its considered Durable Medical Equipment (DME). Part A will cover any inpatient asthma treatments, and Medicare Advantage also covers this.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always be sure to double-check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series, including:

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Medicare Plan Tips Team

Annie Kaye is a writer and researcher who was thrown into the Medicare world while taking care of her ailing mother. Even with a degree in Library Science and a long history of fighting for what's right, she felt lost. She learned a lot about Medicare during that time and now writes to help others understand how the system works.